Hispanic, blacks and women have been disproportionately affected by the AIDS epidemic. Despite increased burden of AIDS cases in these minority populations, access to clinical trials remain low. Puerto Rico (P.R.) ranks second, within all states and territories, in AIDS cases per 100,000 (51.4). AIDS is the leading cause of death for the 20-40 age range group. During the past 5 years, highly significant increments in heterosexual transmission and infection in women have been demonstrated. During the past 3 years we have identified and developed all the necessary infrastructure components for the establishment of an ACTU at the U.P.R., School Medicine. This effort has matured into a research unit with excellent facilities, key research staff, ancillary services and community participation. During our last 6 months we were allowed to enroll patients in ACTG 175. In a 3 month period we evaluated 65 candidates and accrued 16 from all risks behavior groups. As of Dec., 1992, a total of 112 follow-up visits had been recorded with only one missed appointment (visit completion rate of 99%). Only 1 patient was discontinued because of poor compliance and two patients were able to maintain their participation in the protocol by successfully transferring them to ACTU's in USA. It is then, imperative, that an adult ACTU in P.R. be available as a research tool and as a much needed therapeutic alternative.